Depression and Diabetes

If you have both diabetes and depression, you probably don’t care which came first. In fact, the latest research indicates that the two conditions are a two-way street. Sometimes we get depressed first; something we get diabetes first. Does it matter?

Diabetes and depression go together. Research research found that 19 percent of people with type 2 diabetes probably suffer from major depression and an additional two-thirds of us have at least some depressive symptoms. People with diabetes are twice as likely to be depressed as other people.

This reminds me of the futile argument whether being overweight causes diabetes. I an convinced that being overweight doesn’t cause diabetes or vise versa, and in my second book, Losing Weight with Your Diabetes Medication, I devote the entire first chapter to exploring that concept.
But diabetes and depression must have a common cause just like diabetes and being overweight does. Now, we have some tantalizing evidence of what the common cause of diabetes and depression is. This knowledge does matter, because it can give us a way out of the maze.

Members of my diabetes support group deserve our thanks for showing the way. At our most recent meeting two weeks ago Jeff, one member of the group who is working on his dissertation about diabetes and depression, told us about a study that the Archives of Internal Medicine published last year on the diabetes-depression connection. But even more interesting than the study itself is the interview that its lead author, Mercedes R. Carnethon, PhD, of Northwestern University’s Feinberg School of Medicine gave to PsychCentral.

She “theorizes that the culprit responsible for diabetes in persons who are depressed is a high level of a stress hormone, cortisol.” Dr. Carnethon continues, “High levels of cortisol may decrease insulin sensitivity and increase fat deposits around the waist…When people are under acute stress or are depressed, the cells in the pancreas are suppressed and secrete less insulin to enable the body to sweep glucose out of the bloodstream. Compounding the problem, high cortisol levels decrease the muscles’ sensitivity to insulin, which also could result in elevated glucose levels.”

If high levels of cortisol are the missing link, knowing about it can solve the dilemma. This primary stress hormone “curbs functions that would be nonessential or detrimental in a fight-or-flight situation.”

Michael, another member of the diabetes support group, sagely points out that we don’t fight or flee very much any more. Most of us lead sedentary lives.

Michael continues to the final step. “Exercise may help us discharge our excess cortisol.”

So far this is theory. We don’t have proof that exercise will lead us out the the complications of diabetes and depression. But we do know that exercise is essential for controlling our diabetes. It may be essential for controlling our depression too.

The problem, of course, is that when we are depressed, starting an exercise program sounds too hard. It can seem like a terribly long journey.

But, as one of the wisest men who ever lived, Lao Tzu, said about 2500 years ago, “A journey of a thousand miles begins with a single step.”

Or, as novelist Anne Lamont, wrote much more recently, take it “bird by bird.” She tells the story of how when her 10-year-old brother had a challenging report to write on birds and was overwhelmed.

Her father sat down beside Anne’s brother and put his arm around his shoulder. “Bird by bird, buddy,” her father said. “Just take it bird by bird.”

This article is based on an earlier version of my article published by HealthCentral.

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